hormone
A common sign that labor will be short is the so-called bloody show. During pregnancy, a plug of mucus accumulates in the cervical canal, blocking the entrance to the uterus. Approximately 12 days prior to the onset of true labor, this plug loosens and is expelled, along with a small amount of blood. Meanwhile, the posterior pituitary has been boosting its secretion of oxytocin, a hormone that stimulates the contractions of labor. At the same time, the myometrium increases its sensitivity to oxytocin by expressing more receptors for this hormone. As labor nears, oxytocin begins to stimulate stronger, more painful uterine contractions, whichin a positive feedback loopstimulate the secretion of prostaglandins from fetal membranes. Like oxytocin, prostaglandins also enhance uterine contractile strength. The fetal pituitary also secretes oxytocin, which increases prostaglandins even further. Given the importance of oxytocin and prostaglandins to the initiation and maintenance of labor, it is not surprising that, when a pregnancy is not progressing to labor and needs to be induced, a pharmaceutical version of these compounds called pitocin is administered by intravenous drip. Finally, stretching of the myometrium and cervix by a full-term fetus in the vertex head-down position is regarded as a stimulant to uterine contractions. The sum of these changes initiates the regular contractions known as true labor, which become more powerful and more frequent with time. The pain of labor is attributed to myometrial hypoxia during uterine contractions.